Safety: A Cornerstone of Trauma-Informed Care

Learn the value of physical, emotional, and interpersonal safety as part of the healing process.

Trauma affects the entire person. Those who have trauma often display physical and emotional distress and can experience interpersonal struggles and a lack of trust. To create space for healing and recovery, it’s essential to consider an individual’s full trauma history and how past events are impacting their current internal and external perceptions and experiences.

A safe environment is foundational to shifting one’s perspectives and attention toward healing. Although the trauma-causing event may be in the past, the impact of the experience often creates a need and a focus of energy to achieve a sense of safety in the present. What can help in the healing process is to distance themselves from threats and create a safe space to concentrate on their recovery.

Creating a safe and healing environment is why safety is a key principle of delivering trauma-informed care at Hallmark Youthcare. Safety is one of the six pillars outlined in SAMHSA’s trauma-informed care approach, along with trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, and cultural, historical, and gender responsiveness. In this blog series, we will cover each of these principles in-depth. All are important, with safety as a priority early and often; without that foundation, the other elements of trauma-informed care may struggle to gain traction.

Beginning with the pillar of safety, let’s explore what this means in the context of healing and how you can identify a residential behavioral health facility that prioritizes safety as part of their trauma-informed treatment process.

Safety in Trauma-Informed Care, Defined

In the context of behavioral health, we define safety as protecting an individual’s physical, psychological, and emotional well-being throughout all phases of treatment.

According to SAMHSA’s nationally recognized approach, it is imperative that the treatment process itself does not become re-traumatizing. This is a foundational aspect of trauma-informed care – ensuring those seeking support and treatment are not exposed to situations and experiences that can become traumatic. For example, reenacting trauma with restrictive interventions (e.g., seclusion, restraints), verbal aggressiveness, or minimizing one’s experiences can retraumatize individuals — and may limit or compromise the progress that is made in treatment.

However, by prioritizing safety and embedding trauma-informed care principles into all policies, procedures, and practices, providers can help create a recovery-focused environment where an individual can feel comfortable participating in their care. They can confidently share and explore their experiences in a supportive environment without re-traumatization.

How Safety Plays a Role in Trauma-Informed Care

Safety refers to experiencing an absence of immediate harm or danger. For those who have experienced trauma, danger or harm can take many forms:

• Physical
• Psychological
• Emotional

In a trauma-informed setting, the physical surroundings should create a safe and welcoming environment that includes protections such as privacy, cleanliness, and security from harm. Further, staff should recognize the signs and symptoms of trauma and respond with effective and therapeutic procedures and practices that promote healing. Finally, treatment programming and protocols that emphasize safety related to self and others further create a caring and responsive culture within the overall treatment process.

Identifying Safety Measures in a Behavioral Health Facility

When considering a residential behavioral health program, keep in mind a trauma-informed approach can help create the experience of safety. As you tour a facility, explore the practices and procedures where safety plays a key role.

Ask: To what extent do the program’s activities and settings ensure the physical, personal, and psychological safety of residents and staff members? Some questions below may seem basic, but they add to the overall feeling and experience of being safe. Here are a few aspects to consider:

Physical Aspects

• Is the infrastructure (e.g., sidewalks, hallways, bathrooms, green spaces) free and clear of physical hazards? Are the areas neat and tidy?
• Is the walk to and from any buildings a safe walk?
• Are outdoor areas, such as parking lots and green spaces, well lit?
• Is there sufficient indoor lighting and temperature controls?
• Are exits clearly marked and accessible?
• Are doors locked or unlocked? How do guests and residents access various spaces?
• Have past events occurred that impacted residents physical safety?
• Is there a process where visitors must sign in or register to gain entry?

Personal Safety

• Are there cameras monitoring exits and common areas? Are residents made aware of these cameras?
• Are there additional levels of support that can be provided if the resident is struggling?
• Will the treatment team contact family in the event the resident is struggling?
• Are residents provided with appropriate monitoring with visitors?
• Do staff offices have support in urgent or emergent situations, including panic buttons, phones, and emergency systems?
• Are there lockers available to visitors to store items such as cell phones before visitation?
• Are there clear descriptions of the program and those items that are allowed or not allowed within the program detailed in a resident and family handbook?
• Are there appropriate staff available for medical needs, including nursing?
• Are there detailed processes explained to family members on how they can contact the resident?

Psychological and Emotional Safety

• Are staff attuned to signs of distress and respond with compassion and verbal de-escalation techniques?
• Have staff been trained in providing trauma-informed care within the setting?
• Have staff been trained in how to be supportive and therapeutic versus portraying an overly disciplinarian approach?
• Are staff respectful and inclusive with all individuals and their families? When touring, be sure to observe interactions between the staff and residents, and between staff.
• Are there designated quiet spaces for use by residents and staff?
• What is the intake process like? Is it welcoming, respectful, and informational?
• What support is offered to new residents?
• Do staff conduct a thorough assessment of outings, passes, etc., to ensure they will return to a safe environment?
• Is there a formal program that emphasizes safety throughout the treatment including individual, group, and family therapies?

All of these safety considerations also apply to staff members. When staff feel secure and supported, they can be more supportive and impactful in their day-to-day work with residents.

Although the above list is not exhaustive, it is intended to help individuals and their loved ones identify a facility that emphasizes safety, helping to provide the most comprehensive and effective care possible.

Fostering a Culture of Safety at Hallmark Youthcare

Ensuring safety requires an ongoing and proactive approach, one that should be built into the daily culture of a treatment program. The intent is not to check a box, but rather understand how perceptions of physical, psychological, and emotional safety impact outcomes — and deliver effective resident-centered care that fosters resilience and healing.

At Hallmark Youthcare, we are committed to creating a culture of safety for each adolescent in our short-term residential treatment programs. With a trauma-informed care approach and a dedication to continuous improvement, we create the safety and tools our residents need to heal, recover, and thrive.

If you or your teen is struggling, take the first step toward healing by reaching out to us today. We’re here to support your entire path to recovery.

One of the first steps to promote healing from trauma is to create a safe environment where the individual feels they can move forward. According to SAMHSA, safety refers to protecting the “physical, psychological, and emotional well-being” throughout the treatment phase. Learn why safety is one of the core pillars of trauma-informed care and how we create a culture of safety in our latest article.

In trauma-informed care, safety should be a priority early and often; without it, the other elements of care may struggle to gain traction. Learn more about safety as one of the six pillars of SAMHSA’s trauma-informed care approach and how we create a culture of safety.